Tag Archives: pragmatics

More Than Words: Building Social Communication Skills

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Does your child have difficulty playing with other children? Do they prefer to play alone or demonstrate challenges in making friends? This blog will discuss what pragmatic (social) communication is, review the signs of a pragmatic language delay or disorder, and provide strategies for encouraging pragmatic language development in your child.

What is pragmatic language and why is it important?

Pragmatic language or social communication refers to the appropriate use of language in social situations. It is not only what we say, but also how we say it. This includes being able to understand and use nonverbal cues such as body language and facial expressions. Pragmatic language is comprised of various important skills for successful communication, including eye contact, turn-taking, initiating and maintaining conversation, and understanding and using humor, among others. Children may have difficulty with one or more of these skills. It is important to support the development of your child’s pragmatic language skills so that they can learn to express themselves, understand others, and build relationships with family and peers.

Signs of a pragmatic language delay or disorder:

  • Preferring to play alone for an extended period of time
  • Limited eye contact while talking and/or playing
  • Difficulty taking turns
  • Limited initiation of conversation or play
  • Difficulty maintaining a topic of conversation
  • Difficulty participating in pretend play activities
  • Difficulty understanding or expressing emotions
  • Difficulty understanding another’s point of view
  • Difficulty interpreting tone of voice or body language
  • Difficulty making inferences
  • Difficulty using appropriate greetings
  • Difficulty adapting language to different listeners (i.e. talking to a friend the same way as to an adult)
  • Difficulty adapting language based on environment (i.e. talking the same way on the playground as in the classroom)
  • Not providing background information when appropriate

Strategies for building pragmatic language skills:

  • Pretend play:Engage in pretend play activities with your child, such as playing house, pretending to bake cookies, or pretending to be a veterinarian. Pretend play facilitates growth in cooperative back and forth play, ability to act out social situations, and ability to understand another’s perspective.
  • Turn-taking games:Turn-taking is a fundamental skill of communication as it teaches the basic back-and-forth exchange of a conversation. Through turn-taking games children learn to wait when it is someone else’s turn and they learn how to identify when it is their turn. Turn-taking games could be as simple as rolling a ball back and forth or taking turns blowing bubbles. You could also play simple turn-taking board games with your child to support development of this skill.
  • Story time:When reading a book with your child, try to make it interactive. Based on their age and language skills you could ask them to describe the pictures and what they see. For older children you can ask questions such as, “How do you think he feels?” or “What do you think she will do?” Prompting your child to answer these types of questions will help your child to make inferences, learn to understand another person’s perspective, and have a better understanding of emotions.
  • Be a good role model: You are your child’s best teacher. Model appropriate social communication skills such as making appropriate eye contact, using appropriate greetings, asking on-topic follow up questions, etc. Help your child to use these social communication skills when talking to family, teachers, and peers.
  • Facilitating peer interactions:Children need practice in order to learn to share, take turns, and play cooperatively with others. Setting up play-dates that you can be present for is a great way to facilitate peer interactions and relationships. You can encourage your child to communicate with their peer by prompting them to initiate conversation and play ideas. In addition you can encourage them to maintain play and communication with their peer by prompting them to ask on topic questions and make on topic comments.

Questions or concerns?

If you have questions or concerns about your child’s pragmatic language skills, please contact us at info@playworkschicago.com or 773-332-9439.

Claire Kakenmaster, MS, CCC-SLP
Speech Language Pathologist

Photo Credit: Image by HaiRobe on Pixabay

Gender Differences in Autism Spectrum Disorder (ASD)

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Are girls with autism being missed?

A growing body of evidence supports the hypotheses that autism spectrum disorder (ASD) is being underdiagnosed or misdiagnosed in girls. Why might that be? And how could that affect your child? We will delve into a few of these issues in this blog post.

First, an overview of autism spectrum disorder.

What is ASD?

ASD is a biologically based, neurodevelopmental disorder. Meaning, autism is a disorder present at birth that affects how the brain develops. Individuals with ASD often display behaviors that are repetitive in nature and have difficulties participating in social situations. Autism is characterized as a “spectrum disorder” because it presents differently in each individual, causing the symptoms to vary in type and intensity. The current prevalence of autism is 1 in 68 children. Autism is more prevalent in boys, presenting with a ratio of four boys to every one girl with autism spectrum disorder.

Red Flags:

Potential signs of ASD that you might notice in your child are outlined below.

  • Your child does not use gestures to communicate, such as pointing, clapping, or nodding their head
  • Your child does not use a combination of eye contact, gestures, sounds, and words to communicate
  • Your child has a delay in speech and language skills
  • Your child does not imitate actions, sounds, or words that they overhear
  • Your child does not respond when you say their name
  • Your child has sensory differences, including over- or under-sensitivity to certain sounds, textures, smells, etc.
  • Your child has unusual ways of moving their hands or bodies
  • Your child has significant difficulty with transitions
  • Your child does not play with, or similarly to, other children their own age

The red flags outlined above may indicate a difference in your child’s development. If your child exhibits one or more of the red flags mentioned above, it does not necessarily mean that they have autism spectrum disorder. For example, not responding to their name could be due to a potential hearing loss. It is recommended that you discuss any concerns regarding red flags with your child’s medical team, including their pediatrician and therapists.

So, Girls:

Why are they being missed?

As mentioned above, professionals in the field have begun to discuss this issue of underdiagnosis or misdiagnosis of ASD in girls. One potential area of difficulty is that assessments commonly used to diagnose ASD are based on data collected from the general population of children with autism, which consists of more boys than girls. That means the tests are less sensitive to detecting girls with ASD. Girls with well-known or easily understood symptoms will likely not be missed, but those that present with less obvious red flags may be. As ASD is less common in girls it might not be the first diagnosis that comes to mind, especially if symptoms are less severe. Although girls may and do exhibit some of the red flags outlined above, it can present differently or less obviously in girls. It is also common that girls are intrinsically more socially motivated, so symptoms of social communication difficulties may be less obvious.

What does it look like?

A few more specific signs of ASD that you might notice in girls are outlined below.

  • Your child has interests that are age-appropriate but very intense
  • Your child plays with toys in a “pretend” but repetitive manner
  • Your child displays sensory differences, but might begin to hide these as they get older
  • Your child has extreme reactions to change or transitions
  • Your child is exhausted after social interactions
  • Your child has difficulty making or keeping friends
  • Your child has difficulty with conversational skills, such as topic maintenance and turn taking
  • Your child may internalize their emotions, resulting in anxiety

How does this affect your child?

The slight variation in type or intensity of red flags in girls may cause them to be diagnosed with something other than autism spectrum disorder, such as an anxiety disorder or a language disorder. The misdiagnosis results in recommendations that may be less appropriate or encompassing of symptoms and may result in your child missing out on early intervention strategies to support their development.

What can I do? 

If your child is demonstrating the behaviors above, or any general red flags for autism spectrum disorder, consider following up with your child’s therapist or pediatrician. Although individual speech-language therapists cannot provide a diagnosis of autism spectrum disorder, they can make appropriate referrals for testing and possible diagnosis.

Questions or concerns?

If you have questions or concerns about your child’s development, please contact us at info@playworkschicago.com or 773-332-9439.

Ana Thrall Burgoon, M.S., CCC – SLP 
Speech-Language Pathologist

References:

Bartley, Janine. “Autism Spectrum Disorder.” Grand Valley State University, 4 Dec. 2018, Grand Rapids. Lecture.

Rudy, L. (2018, December 4). Symptoms of Autism in Girls . In VeryWell Health .

Volkers, N. (2018, April). Invisible Girls. The ASHA Leader, 23(4), 48-55.

Photo Credit: Photo by Jens Johnsson on Unsplash

Speech Therapy: Debunked

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Most people have had some exposure or connection to speech and language therapy, whether it was for themselves, a friend, or a family member. It could be that your child has recently been recommended speech therapy and you are not sure what this will entail. In this blog, I hope to debunk a few common misconceptions regarding speech and language therapy, as well as provide a brief overview of the field of pediatric speech-language pathology.

Common Myths and Misconceptions: Debunked
While it may look to the outside world that we are simply playing with toys and games, there is a method to this play-based madness. Our job is to find out what motivates your child and use it to target their therapy goals. When your child is a toddler, this might mean making a cow jump over a barn. While that isfun, your speech therapist may be working on improving your child’s engagement and ability to imitate play-actions, which will hopefully lead them to imitating sounds and words. A population that is often thought of when discussing speech therapy are those with disfluencies, or those who stutter. This is true but is a small percentage of children worked with for a general speech therapist. Articulation therapy is another familiar area, as many of my friends remember being pulled-out of class to play Candyland and work on speech sounds as a child.  Although I do own Candyland and use it semi-regularly, there is so much more we, as speech-language pathologists, do to help improve your child’s communication skills.

What is speech and language therapy?

Variety is the spice of life, and as speech therapists, we get a good taste of this! Speech therapists have a broad scope of practice when it comes to the pediatric population. Below are a few of the most common areas a speech therapist might help your child with.

  • Articulation/Phonology:The actual sounds your child makes to create words.
  • Motor planning:Your child’s ability to plan and execute the fine motor movements required to speak in words, phrases and conversation.
  • Language:The words and phrases your child both usesand understands.
  • Feeding:This involves oral-motors skills like sucking, chewing and swallowing. Also, the sensory processing of different textures, tastes and consistencies.
  • Voice:Your child’s vocal quality. Is it appropriate for a child their age and size or is it breathy or hoarse?
  • Fluency:The way your child’s speech flows.
  • Pragmatics:Your child’s social communication skills, such as making eye-contact, initiating communication with peers, and taking conversational turns.
  • Advocacy: Your child could benefit from additional therapies that you may not be aware of. Your speech therapist can help advocate for your child to ensure they get the best possible care from a qualified team of providers, if necessary.

If your child is demonstrating difficulty in one or many of the areas above, consider contacting one of our speech-language therapists.

Questions or concerns?

If you have questions or concerns about your child’s communication or feeding skills, please contact us at info@playworkschicago.com or 773-332-9439.

Ana Thrall Burgoon, M.S., CCC – SLP 
Speech-Language Pathologist

Photo Credit: Photo by Leo Rivas on Unsplash